About 10 percent of children have some kind of communication disorder, including speech, language or hearing problems. Among the most common are:

Articulation disorders– Difficulty producing clear speech sounds. Account for about 75 percent of all communication disorders. The three most common variations are: substitution of one sound for another ; omission of a sound (“cat” may be pronounced “ca”); and slight distortion of a sound, as in lisping (“this” may sound like “thith”). By age 7, a child should be able to produce all sounds and sound combinations.

Language development disorders – Delays in expression, processing and comprehension. Expressive disorders are reflected in reduced vocabulary, short utterances, an inability to master grammar (such as plurals or past tense), or using many words to explain a specific term. A child with these disorders may also have difficulty finding and retrieving words (characterized by substitutions such as “mat” for “map”; word switches such as “hat” for “scarf”; or the use of nonspecific words such as “like” or “stuff”).

Receptive (comprehension) disorders involve trouble following multistep instructions or figuring out intended meanings without the help of gestures and cues. Other comprehension difficulties may be impacted by reduced attention span and memory functions. Language development disorders can be detected as early as 12 to 18 months but may become more evident as a child’s language skills develop

Voice disorders– Loudness, pitch or quality of voice is so unusual that it distracts listeners. Variations include hoarseness, harshness, breathiness and shrillness, speaking too loudly or softly or at a pitch higher or lower than is standard for age and sex. These disorders are not age specific, but children are typically not treated for hoarseness until they are older than 4 years old. Hoarseness may result from a medical problem and needs to be evaluated by an otolaryngologist

Fluency disorders – Disruptions in the natural rhythm and flow of speech, including pauses, hesitations, interjections, prolongation or repetition of syllables, and interruptions. Stuttering, the most common of these disorders, is a normal part of early childhood (2-1/2 to 4 years), but may require direct services if it increases in severity and continues past age 5.